Network and Healthcare Management & Strategy, Analyst

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About the Role

1. To manage (administration related matters) panel of healthcare providers that provides medical services with cashless facility to covered members and policyholders of AIA health insurance policies.
2. To support claims operations and act as intermediary for operational matters between panel providers and AIA Health Services.
3. Responsible for maintaining providers system set-up, updating and prompt communication for smooth operation between providers & AIA

Roles & Responsibilities:

1. Network Management

Hospital Panel-ship

• To provide the relevant assessment study on new panel provider applicant and provide recommendations based on credentialing guidelines and requirements.
• To support the process of deliberation by the Hospital Specialist Review Committee which includes documentation and site visits.

Provider Engagement

• To provide and receive feedback from providers for mutual improvement.

Contracting

• To support the negotiation of provider contract to gain strong commercial improvements and delivery of major cost savings.
• To be ensure necessary contracts are renewed before expiry, i.e. package pricing contracts and to continuously follow up to ensure contracts are closed within a reasonable time period.

Relationship Management/Communication

• To oversee the handling of complaints from internal and external clients on services related issues by panel providers especially issues related to claims and GL TATs & SLAs.
• To oversee and track swift resolution of claims and GL issues related to internal AHS processes thru active operations meeting and interventions.
• To conduct provider training sessions and proactively communicate with panel providers on new procedures and/or urgent updates to daily operational requirements of AHS

2. Business Development

• To coordinate business events with providers including meetings, official openings, launches, etc.
• To develop and disseminate marketing materials related to packages and Platinum provider with assistance from Provider Business Associates.
• To develop and bridge the relationship between Agency with package and Platinum providers.
• To follow up and close the Addendums for package pricing and terms renegotiations with providers.

3. Alliance Management

• To drive steerage to Platinum and package pricing partners
• To proactively manage the allocation and promotion of health events to preferred or package partners.

4. Others

• To perform other tasks as and when required

Minimum Job Requirements:

• Degree/Diploma in Health or Life Sciences, Allied Health or relevant disciplines
• Working experience in healthcare or managed care or insurance industry.
• Knowledge in healthcare management, experience in nursing and medical advancement.
• Good verbal and written communication skills, problem solving skills, able to manage people, fundamental knowledge in accounting principles, good analytical skills, proficiency in basic computer operating software like MS Office, willing to travel for job assignments.